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Immunizations—vaccination shots given to prevent infectious diseases are most often associated with childhood—but in fact, some diseases affect older folks more than children. Keeping your vaccines up to date will help you avoid discomfort or potentially serious illness and also reduce the risk of spreading serious preventable illnesses to your children, grandkids, and others in the community. If you’re an older adult, talk to your doctor about the following vaccines.

For most seniors

Shingles: The virus that causes childhood chicken pox can lead to shingles in seniors, staying dormant in the body and being reactivated years later, causing extremely painful sores on the body or face. Some people develop post-infection nerve pain (neuralgia) that can linger for months or years.

What helps? Vaccinating against shingles prevents reactivation of the chicken pox virus and protects against painful long-term complications. The US Centers for Disease Control and Prevention (CDC) recommends all adults over age 60 be vaccinated against shingles if they’ve ever had chicken pox, or been exposed to the virus. No vaccine is 100% effective, but even if you develop the disease the vaccine can lessen its severity.

Influenza: In the US and Europe, “the flu” is most active in the late fall, winter, and early spring. The flu virus comes around every year but changes over time, which means last year’s vaccination won’t protect against this year’s bug. In older adults, influenza can lead to serious complications including pneumonia and even death.

What helps? According to the CDC, a yearly influenza vaccination is especially important for seniors. During a regular flu season, approximately 90% of flu-related deaths occur in people 65 years and older. Though you can benefit from a vaccination later in the season, full immunity takes a few weeks to develop, so getting your flu shot in early fall will ensure you’re most protected during the peak flu months of late winter.

Pertussis: When adults get pertussis, they don’t tend to get the “whoop” in the cough that characterizes the disease in children, so they may not know they have it. While pertussis infection is generally not life-threatening for adults, adults can spread it to children, who may get very sick. For infants under one year, pertussis can be deadly.

What helps? Even for those vaccinated as children, no vaccination lasts a lifetime, so many adults are not protected. A booster shot can help prevent adults from catching and spreading the disease to vulnerable kids.

Measles, Mumps, and Rubella (MMR): Spread through the air when an infected person breathes, coughs, or sneezes, measles, mumps, and rubella (German measles) are highly contagious and infectious, and can have serious health consequences. Measles can lead to pneumonia and ear infections, with permanent hearing loss. Mumps can lead to meningitis (infection and inflammation of the tissue covering the brain and spinal cord). Rubella tends to be non-life-threatening in older adults, but if spread to a pregnant woman, it can lead to severe birth defects in her baby.

What helps? Most adults born before 1957 are immune to measles and mumps. These diseases were more common before this date, and many people were exposed to the viruses as children, leading to natural immunity. If you were born after 1957, the CDC recommends you receive an MMR vaccine booster as an adult. If you haven’t had one or aren’t sure, ask your doctor.

Pneumonia: Pneumonia is an inflammatory condition of the lung typically caused by infection, which can cause cough, chest pain, fever, and difficulty breathing. It can be life-threatening in older people.

Protecting against pneumonia caused by the Pneumococcus (Streptococcus pneumoniae) bacterium, this vaccine is especially important for adults with chronic heart, lung, or liver diseases, or sickle cell anemia, as these folks are at increased risk. Adults over 65 years are at the highest risk of serious illness and death due to this type of pneumonia.

For seniors 65 years and older with a chronic condition, such as diabetes, ask your doctor if you need additional vaccinations from diseases such as meningococcal meningitis or a booster shot for polio.

For seniors abroad

If your golden years include trips to exotic locales outside your own country, there are special precautions you can take to protect yourself against unnecessary infections. Nothing puts a damper on the “trip of a lifetime” like a serious infection or landing in a foreign hospital. Before you book your tickets, ask your doctor if any of the locations you are visiting require vaccinations in advance to protect your health.

Typhoid, hepatitis A and B, Japanese encephalitis, meningitis, and yellow fever: Depending on where you go, and the types of adventures you seek out, you may need to consider being vaccinated against these types of diseases.

Rabies: While most travel clinics do not routinely vaccinate against rabies, if you are traveling to a rabies-endemic area and may be exposed to wildlife or stray domestic animals, ask your doctor if you need this vaccination as well.

Malaria: While there is no vaccine against malaria at this time, medications can be taken before and during your trip to lessen the chances you develop this very serious parasitic infection.

Get organized

Some pharmacies now offer the less commonly sought out vaccinations, including many of those required by those traveling abroad. Nearly all insurers will cover the cost of a flu vaccine, but check with your insurance about the others and talk to your doctor to determine which vaccines make most sense for you. You may balk at paying for a vaccination out of pocket, but many of them can save you a lot of pain and suffering later, and may even save you money in the co-pays and doctor’s fees you won’t pay because you didn’t get sick.

To keep track of vaccinations and maximize their effectiveness:

Stay regular. Try to visit the same pharmacy every year so they have a full record of which vaccinations you’ve received and when.

Keep track. Note your vaccinations in your computer or calendar. High-tech folks can set a reminder alarm. The technically challenged should be sure to file the information in a health folder.

Always inform. Tell your doctor or pharmacist if you have underlying health conditions, such as diabetes, or if you take medications that can affect the immune system.

Consider probiotics. Research suggests that probiotic supplements may boost immune response to vaccination (Bifidobacteriumanimalis subspecies lactis [BB-12] and Lactobacillus paracasei subspecies paracasei [L. casei 431] appear to work best). For best effect take them daily for a few days to a couple of weeks prior to vaccination, and continue for several weeks after. If you are immune-compromised or have other serious health conditions, ask your doctor if probiotics are safe for you.

Take a walk. Getting regular exercise can boost the effectiveness of vaccinations.

Ask about doublingup. Some vaccinations don’t work as well in older adults who may need a higher dose to fully stimulate the immune system. Ask your doctor if you should get additional doses of any vaccine you receive.

Suzanne Dixon, MPH, MS, RD, an author, speaker, and internationally recognized expert in chronic disease prevention, epidemiology, and nutrition, has taught medical, nursing, public health, and alternative medicine coursework. She has delivered over 150 invited lectures to health professionals and consumers and is the creator of a nutrition website acclaimed by the New York Times and Time magazine. Suzanne received her training in epidemiology and nutrition at the University of Michigan, School of Public Health at Ann Arbor.